基于药物的身体功能指标（MedIP）的开发和评估。
Development and evaluation of the medication-based index of physical function (MedIP).
机构信息
Department of Physical Therapy, College of Clinical and Rehabilitative Health Sciences, East Tennessee State University, Johnson City, TN, USA.
Auditory and Vestibular Dysfunction Research Enhancement Award Program, James H. Quillen VA Medical Center, Mountain Home, TN, USA.
出版信息
Age Ageing. 2017 Sep 1;46(5):761-766. doi: 10.1093/ageing/afx056.
BACKGROUND
the development of an objective and comprehensive drug-based index of physical function for older adults has the potential to more accurately predict fall risk.
DESIGN
the index was developed using 862 adults (ages 57-85) from the National Social Life, Health, and Aging Project (NSHAP) Wave 1 study. The index was evaluated in 70 adults (ages 51-88) from a rehabilitation study of dizziness and balance.
METHODS
the prevalence among 601 drugs for 1,694 side effects was used with fall history to determine the magnitude of each side effect's contribution towards physical function. This information was used to calculate a Medication-based Index of Physical function (MedIP) score for each individual based on his or her medication profile. The MedIP was compared to the timed up and go (TUG) test as well as drug counts using receiver operating characteristic (ROC) analysis. The associations between various indices of physical function and MedIP were calculated.
RESULTS
within the NSHAP data set, the MedIP was better than drug counts or TUG at predicting falls based on ROC analysis. Using scores above and below the cutpoint, the MedIP was a significant predictor of falls (OR = 2.61 [95% CI 1.83, 3.64]; P < 0.001). Using an external data set, it was shown that the MedIP was significantly correlated with fall number (P = 0.044), composite physical function (P = 0.026) and preferred gait speed (P = 0.043).
CONCLUSION
the MedIP has the potential to become a useful tool in the healthcare and fall prevention of older individuals.
背景
为老年人开发一种基于药物的客观、全面的身体功能指标，有可能更准确地预测跌倒风险。
设计
该指标是使用来自国家社会生活、健康和老龄化项目（NSHAP）第 1 波研究的 862 名年龄在 57-85 岁的成年人开发的。该指数在来自头晕和平衡康复研究的 70 名年龄在 51-88 岁的成年人中进行了评估。
方法
使用 601 种药物的 1694 种副作用的患病率，结合跌倒史，确定每种副作用对身体功能的影响程度。根据个人的药物使用情况，利用这些信息为每个人计算一个基于药物的身体功能指数（MedIP）评分。将 MedIP 与计时起身行走测试（TUG）以及药物计数进行比较，使用接受者操作特征（ROC）分析。计算各种身体功能指标与 MedIP 之间的关联。
结果
在 NSHAP 数据集内，MedIP 在预测跌倒方面优于药物计数或 TUG 通过 ROC 分析。使用高于和低于临界值的分数，MedIP 是跌倒的显著预测因子（OR = 2.61 [95%CI 1.83, 3.64]；P < 0.001）。使用外部数据集表明，MedIP 与跌倒次数（P = 0.044）、综合身体功能（P = 0.026）和首选行走速度（P = 0.043）显著相关。
结论
MedIP 有可能成为老年人医疗保健和预防跌倒的有用工具。
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